Sunday, 18 May 2014

Offer of sex change drugs to nine year olds should make us question therapists’ ideological presuppositions

Children as young as nine are to be prescribed drugs which
delay the onset of puberty as the first step towards a sex change operation (Mail
on Sunday and Daily
Telegraph).

Doctors at the Tavistock and Portman NHS Foundation Trust
said a trial of the treatment on ‘gender dysphoria’ patients
aged 12 to 14 had been successful and it could now be offered even earlier.

Monthly injections of the drugs, known as hypothalamic
blockers, are used to slow the development of the children’s sexual organs by
blocking the production of the hormones testosterone and oestrogen.

The rationale is that by delaying the onset of sexual maturation
this gives more time for gender conflicted youngsters to decide whether they
wish to embark on hormone treatment and surgery aimed at changing their
gender.

Most people will be shocked at this news but it is actually
a logical consequence of accepting four prior ideological presuppositions –
that gender is a social construct, that personal autonomy should trump other
considerations, that emotional suffering should be avoided at all costs and
that technology should be used to achieve these ends.

There are obvious safety concerns - although the gender
treatment is reversible, the long-term effects on brain development, bone
growth and fertility have not yet been fully evaluated.

But safety considerations aside, using hormones to suppress
puberty in transgender children is highly controversial, not least because of
deep societal disagreements about the causes and nature of transsexuality and
the effectiveness and appropriateness of transgender therapies per se. This
means that therapists remain strongly divided about the best way of handling
the issue.

Transgender people are born with the anatomy and physiology
of one sex but believe that they belong to the opposite sex. Should
therapy therefore be aimed at changing bodies (using hormones and surgery) to
match a person’s beliefs or should it rather be aimed at helping people to
adjust mentally to accepting the bodies they were born with? Even more
fundamentally, is ‘gender dsyphoria’ a mental disorder or is it just a normal
variant like eye or skin colour?

Up until recently ‘gender identity disorder’ was classified
as a mental disorder (in the Psychiatric diagnostic inventory DSM-IV) but it
has now been reclassified and renamed ‘gender dysphoria’ (in the DSM-V). This
change was strongly ideologically driven and many psychologists and
psychiatrists dispute the reclassification. They still see ‘gender identity
disorder’ as a kind of body dysphoria, whereby a person has an unshakeable
false belief that they are one sex when in fact they are the other. It has been
likened to anorexia nervosa, where the affected individual is convinced she is
fat whilst being grossly underweight.

Those who supported the reclassification however, take the
view that gender identity is biologically fixed and determined and that it is
harmful to affected individuals to deny them sex change therapy or to 'force' them
to live with the body they were born with. Some even hold to the strongly
postmodern view that gender, regardless of what one’s genes or hormones
suggest, is simply a social construct, even a matter of choice. If you wish to
appreciate how passionately these views are held, then try expressing a traditional understanding on twitter using the hashtag #lgbt!

Is gender identity fixed as male or female or is it more of
a spectrum or continuum? Can it change over time? How effective is therapy is
changing the strength and orientation of one’s beliefs? How might suppression
of puberty using hormonal treatment affect bone, brain and sexual development?

Research is still at an early stage with many of these
questions and strong ideological convictions one way or the other mean that
scientific objectivity about the real effects of sex change therapy may always
be a matter of contention. It is perhaps not surprising that both
opinion and research in this whole area is often driven by powerful ideological
vested interests.

Complicating this is the fact that gender identity may
change in an individual over time, and that it may be very difficult to predict
the outcome of for any particular person. Some children are much more
appropriately described as ‘gender nonconforming’ or ‘gender-fluid’ rather than
transgender. In many others gender identity may change with time.

Toronto specialist Ken Zucker,
who opposes the use of sex change therapies, claims that only about 12% of boys
and girls with gender dysphoria will still have persistent dysphoria as adults.
This fact alone should lead even the most committed supporters of early
intervention to err strongly on the side of caution.

The CMF File ‘Gender
Identity Disorder’ goes into the issue in more detail and also looks
at biblical principles which can be applied.

The Bible teaches that human beings are created in God's
image and of two sexes – male and female (Genesis 1:27). Jesus drew on
this when he commented, 'haven't you read, that at the beginning the Creator
“made them male and female”, and said, “For this reason a man will leave his
father and mother and be united to his wife, and the two will become one flesh”
(Matthew 19:4-5).

The Old Testament command 'you shall not commit adultery'
also indicates that sexual intercourse should only occur within the framework
of marriage (Exodus 20:14). Sex outside the marriage bond is wrong,
whether with someone of the same or opposite sex (Leviticus 18:22, 20:10).

The ideal pattern for existence was spoilt at the Fall when
mankind rebelled against God's rules. One consequence of this is that moral
values, sexual patterns and also biology (genes and hormones) have become
distorted.

The good news at the centre of Christianity is that Jesus,
through his death and resurrection, gives people new life and power to change.
On top of this, there will be a time in the future when all rebellion against
God's plans will come to an end and a perfect relationship with God can be
fully restored. This brings the hope that transsexual people may find support
as they seek to live in ways that are honest to the way God made them, and open
to God's ideals.

It's worth noting that the Bible regards celibacy as a high
calling. Jesus was fully human and male, but never married nor had sexual
intercourse. He also taught that marriage is not for everyone (Matthew 19:12). It is important to acknowledge this, as for some people, battling with gender conflict may be a life long process.

4 comments:

Thank you Peter, you always give the sane and godly view!I think the most glaring idealogical disconnect may be that between the eager encouragement of those wishing to "change" their biological sex - never mind that it's physically impossible; and the push to criminalise attempts to change sexual orientation, which (to put it no more strongly) is not.

Thank you, Mr. Saunders, for this article. When I read about hypothalamic blockers being given to 9-year-olds, I searched on the web for their side-effects but found little. Then I found your post that also gives information on whether gender identity disorder is "real" or psychological.

I can not say I agree with you that the reasons why these kids are gender phosphoric in the first place is because mankind has gone against gods will and having intercourse outside of wedlock. That would seem a lot like a punishment as god is supposed to be the all forgiving farther of mankind.

Gender identity disorder is definitely a real disorder, just the same a homosexuality or anything else that might make up a human beings personality or sexuality. At the end of the day let them be their own person and your time will be better spent minding your own business. Period.

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Kiwi, Christian and Medical

This blog deals mainly with matters at the interface of Christianity and Medicine. But I do also diverge into other subjects - especially New Zealand, rugby, economics, developing world, politics and topics of general Christian and/or medical interest. The opinions expressed here are mine and may not necessarily reflect the views of my employer or anyone else associated with me.

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I am CEO of Christian Medical Fellowship, a UK-based organisation with 4,500 UK doctors and 1,000 medical students as members. The opinions expressed here however are mine, and may not necessarily reflect the views of CMF or anyone else associated with me.